Dysregulation of Glucocorticoid Receptor Homeostasis and Glucocorticoid-Associated Genes in Umbilical Cord Endothelial Cells of Diet-Induced Obese Pregnant Sheep.

Maternal obesity (MO) is associated with offspring cardiometabolic diseases that are hypothesized to be partly mediated by glucocorticoids. Therefore, we aimed to study fetal endothelial glucocorticoid sensitivity in an ovine model of MO. Rambouillet/Columbia ewes were fed either 100% (control) or 150% (MO) National Research Council recommendations from 60 d before mating until near-term (135 days gestation).

A Leg to Stand On: Working With Marginal Decision-making Capacity in a Patient With a Severe Leg Infection and Schizophrenia.

Assessment of a patient's capacity to make treatment decisions and working with the wishes of a patient with mental illness against the best medically indicated plan is a complex and dynamic task. It is particularly challenging when the course of deterioration of the illness is meandering and slow, and the time horizon for recovery is uncertain, providing no clear point of entry for definitive crisis intervention. High-impact decisions concerning body integrity, such as the amputation of a leg, further complicate the task.

Experiences of Family Burden in Caring for the Severely Mentally Ill in a Foreign Land: A Qualitative Study of Chinese Immigrant Families in Toronto, Canada.

There is a relative dearth of qualitative studies on the actual experiences of families caring for members suffering from serious mental illness, and even less is known about disadvantaged ethnic minority immigrant families. This explorative qualitative study examines the burden experienced by 15 family members of Chinese immigrant background in Toronto, Canada. Six common themes emerged from the study: 1) significant worries about not being able to take care of ill members in the future; 2) on-going strain and changed family life; 3) pervasive social stigma, discrimination and lack of resources; 4) general appreciation of Canadian health and welfare systems and opportunities; 5) cultural factors and beliefs uniquely shape families' support and caring commitment; and 6) families find various ways to cope and help themselves.

Vinorelbine Augments Radiotherapy in Hepatocellular Carcinoma.

There is a need to improve the effectiveness of radiotherapy (RT) in hepatocellular carcinoma (HCC). Therefore, the purpose of this study was to explore the efficacy and toxicity of the anti-microtubule agent Vinorelbine as a radiosensitizer in HCC. The radio sensitivity of 16 HCC patient-derived xenograft (PDX) models was determined by quantifying the survival fraction following irradiation in vitro, and Vinorelbine radio sensitization was determined by clonogenic assay.

Risk factors associated with life jacket wear among adult canoeists and kayakers in the United States, 1999-2017.

Drowning is the most common cause of death in recreational boating. Life jackets prevent drowning, yet adult wear rates remain relatively low on most types of boats. Canoes and kayaks are among the least used boat types, yet maintain the third and first highest annual boating-related drowning rates in 2012, respectively.

Effectiveness of an Assertive Community Treatment program for people with severe schizophrenia in mainland China - a 12-month randomized controlled trial.

Background: Assertive Community Treatment (ACT) is an evidence-based treatment program for people with severe mental illness developed in high-income countries. We report the first randomized controlled trial of ACT in mainland China.

Methods: Sixty outpatients with schizophrenia with severe functional impairments or frequent hospitalizations were randomly assigned to ACT (n = 30) or standard community treatment (n = 30).

Food Access and Its Relationship to Perceived Walkability, Safety, and Social Cohesion.

Understanding social inequalities in terms of neighborhood characteristics and the context to which individuals belong is important for reducing disparities. This article describes how perceptions of food access are related to three physical and social environmental factors: perceived neighborhood walkability, safety, and social cohesion. A cross-sectional survey was conducted with a random sample of 1,500 households in Springfield, Missouri.

Factors associated with life jacket use among cabin sailboat and day sailor boaters in the United States.

Introduction: In 2015, drowning accounted for 68% of the 626 recreational boating related deaths in the United States. Although life jackets are estimated to prevent between 50% to 80% of boating deaths, approximately 83% of sailboat-related drowning victims were reported to not be wearing life jackets. Life jacket use among adult boaters has remained consistently low across most boat types and may vary by boater, boating, and environmental conditions.

Use of life jackets and other types of flotation for in-water recreation in designated swim areas in Washington State.

Unlabelled: Most fatal drownings worldwide occur in open water. Flotation devices may protect swimmers. Their use by those recreating in water has not been described.

Healthy Futures Program and Adolescent Sexual Behaviors in 3 Massachusetts Cities: A Randomized Controlled Trial.

Objectives: We evaluated the impact of the 3-year Healthy Futures program on reducing sexual behaviors among middle school students.

Methods: Fifteen public middle schools in Haverhill, Lowell, and Lynn, Massachusetts, participated in this longitudinal school-cluster randomized controlled trial (2011-2015), which included 1344 boys and girls. We collected student survey data at baseline, immediately after each Nu-CULTURE curriculum (classroom component of Healthy Futures) in the sixth, seventh, and eighth grades, and at a 1-year follow-up in the ninth grade (cohort 1 students only).

The Value of Experiential Sexually Transmitted Disease Clinical Training in the Digital Age.

Background: The translation of evidence-based guidelines for sexually transmitted disease (STD) care into clinical practice is crucial for the prevention and control of STDs.

Methods: Participants in a hands-on, multifaceted, small-group STD Clinical Intensive Course from 2006 to 2013 were asked to complete a survey regarding course content and value compared with other continuing education courses. Survey respondents with demographic and professional information were compared with all other course participants.

First adaptation of a family-based ACT model in mainland China: a pilot project.

Objective: This study reports findings from a preliminary evaluation of the first implementation of the assertive community treatment (ACT) model in mainland China.

Methods: Over six months, the pilot study compared a group of patients (N=15) and family caregivers who received ACT services with a control group (N=16) who received standard community services. Data on hospitalization days, relapse frequency, psychiatric symptoms, social and vocational functioning, general mental health status, family burden, and level of social support for family caregivers were examined.

Barriers to cervical cancer screening and follow-up care among Black Women in Massachusetts.

Objective: To explore factors that might lead to delays in appropriate cervical cancer screening and diagnosis among Black women in Massachusetts.

Design: Qualitative using focus groups.

Setting: Hospitals, health centers, and community-based organizations in Boston, Massachusetts.

Changing life jacket wearing behavior: an evaluation of two approaches.

In the United States during 1999-2012, about 4 per cent of adults wore life jackets while engaged in recreation on powerboats. Educational campaigns have promoted life jacket use. Mandatory use regulations target primarily children or boaters on personal watercrafts or water skiing.

Improved quality of HIV care over time among participants in a national quality improvement initiative.

Ensuring comprehensive quality HIV and primary care is critical for effective HIV management. This study evaluates the impact of long-term engagement in a quality management (QM) initiative on performance measures. HIVQUAL-US is a federally-funded program to build clinic QM capacity to improve care for people living with HIV/AIDS.

Trends in life jacket wear among recreational boaters: a dozen years (1999-2010) of US observational data.

We report results from 12 years of US observational data on life jacket use among recreational boaters based on more than 480,000 boaters in 175,000 boats between 1999 and 2010. The overall wear rate was 21.7 per cent, with sharp differences by age and boat types.

Adapting ACT to serve culturally diverse communities: a comparison of a Japanese and a Canadian ACT team.

Objective: The assertive community treatment (ACT) teams of Mount Sinai Hospital in Toronto and the KUINA Center, Hitachinaka, Japan, were compared with regard to ACT fidelity, organizational structure, populations served, and treatment outcomes. Ethnocultural adaptations to the ACT model made by both teams included enhanced family support and intervention, culturally and linguistically matched staff and patients when possible, culturally informed therapy, routine cultural assessments, culturally matched housing and community support, and flexible funding models.

Methods: Data were gathered by chart reviews (66 patients in Toronto and 40 patients in Japan), a satisfaction measure, a standard measure of ACT fidelity, and a pre-post measure of treatment outcomes (the Brief Psychiatric Rating Scale), and hospitalization days.

Multi-family psycho-education group for assertive community treatment clients and families of culturally diverse background: a pilot study.

This study evaluates the incorporation of Multi-Family Psycho-education Group (MFPG) to an Assertive Community Treatment Team developed to serve culturally diverse clients who suffers from severe mental illness. Participants included Chinese and Tamil clients and their family members. Family members' well-being, perceived burden, and acceptance of clients were assessed before and after the intervention.

Long-term care: a health promotion challenge.

There is a lack of health promotion for the elderly residing in long-term care facilities. It becomes imperative therefore for the nursing profession to readjust its thinking and practice to include health promotion strategies and interventions for institutionalized elderly in the long-term care sector. From using the empowerment theory in the discussion it is clear that nurses can help the elderly receive health promotion strategies and interventions to help the older person make informed choices about their lifestyle, health and treatment.